tbuckley/cabot-search huggingface dataset:
AB0706 AGGLOMERATIVE HIERARCHICAL CLUSTER ANALYSIS IDENTIFIES TWO CLUSTERS OF TAKAYASU ARTERITIS BASED ON CLINICAL PHENOTYPE WHICH PREDICT ANGIOGRAPHIC FINDINGS AND MORTALITY IN A COHORT OF 200 PATIENTS
Authors: K. Singh, S. Ganapathy, C. Kavadichanda, U. Rathore, N. Jain, M. Ora, V. Agarwal, D. P. Misra
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Cluster analysis is a data-driven approach to identify natural patterns of disease which may help better understand the phenotype of Takayasu arteritis (TAK), a rare large vessel vasculitis. <h3>Objectives</h3> To evaluate whether clusters based on clinical phenotypes of TAK predict angiographic patterns of disease or mortality. <h3>Methods</h3> From a retrospective cohort of TAK, agglomerative hierarchical clustering using Ward method was performed using clinical features. Optimal number of clusters were identified using elbow method and silhouette method. The hitherto identified clusters were compared for differences in clinical features, vascular involvement, and Hata's angiographic subtypes using odds ratios (OR, with 95% confidence intervals), and for survival (crude, using Kaplan-Meier curves; adjusted for gender and age of disease onset using Cox regression analyses) using STATA 16.1 I/C. <h3>Results</h3> Optimal number of clusters was two [Ward agglomerative coefficient 0.989; Cluster 1: 111 TAK, mean (SD) age 25.06 (9.97) years, 80.2% females; Cluster 2: 89 TAK, mean (SD) age 25.54 (10.38) years, 65.2% females]. Carotidynia, pulse or BP inequality, pulse loss, vascular bruits, upper limb claudication, lower limb claudication, and chest pain were more common in cluster 1, whereas, hypertension, renal failure, and stroke/TIA were more common in cluster 2 (Table 1). Involvement of subclavian and carotid arteries, left vertebral, brachiocephalic, ascending aorta, arch of aorta, descending thoracic aorta were more common in cluster 1, whereas, abdominal aorta, celiac, superior mesenteric, inferior mesenteric, left and right renal arteries were similar in both clusters. Hata's angiographic subtype V was more common in cluster 1 (OR 0.45, 95%CI 0.25 – 0.80), whereas, subtype IV was more common in cluster 2 (OR 6.16, 95%CI 1.70 – 22.35). Over 697 person-years of follow-up (193 patients), cluster 1 had worse survival than cluster 2 (log-rank p value 0.027, Figure 1), even after adjustment for gender and age of onset (adjusted Hazard ratio cluster 2 vs cluster 1 0.09, 95%CI 0.01 – 0.78). <h3>Conclusion</h3> Clinical features corresponded to vascular territories which were more common in cluster 1. Hypertension and renal failure were more common in cluster 2, which correspond to more frequent Hata's subtype IV in this cluster. Clusters based on clinical features could predict well the patterns of vascular involvement. Higher adjusted mortality rate in cluster 1 requires validation in other cohorts of TAK. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0597 CLINICAL SIGNIFICANCE OF ANTI-RHEUMATOID ARTHRITIS 33 ANTIBODY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Y. Chen, W. Y. Lu, D. Liu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Evidence initially showed that anti-rheumatoid arthritis (RA) 33 antibodies were highly specific for the diagnosis of RA <sup>[1]</sup>. Later studies reported that anti-RA33 was present in various connective tissue diseases (CTDs) <sup>[2]</sup>. However, the clinical significance of anti-RA33 antibodies in CTDs is still obscure. <h3>Objectives</h3> To explore the clinical significance and diagnostic value of anti-RA33 antibodies in CTDs, especially systemic lupus erythematosus (SLE). <h3>Methods</h3> A total of 565 patients with positive anti-nuclear antibodies who had been tested for anti-RA33 antibodies were included in the study. These patients were classified into RA33-positive and RA33-negative groups according to the anti-RA33 results. The association between anti-RA33 and the clinical features of CTDs was examined. Additionally, receiver operating characteristic (ROC) analysis was performed to explore the diagnostic value of anti-RA33 antibodies in SLE and SLE-related organ involvement. <h3>Results</h3> SLE was the most common disease in CTD patients positive for anti-RA33 (48.8%). Compared with the RA33-negative group, the proportion of patients with SLE was significantly higher in the RA33-positive group (64.3% vs. 47.1%, p=0.0164). Compared with those negative for anti-RA33, CTD patients positive for anti-RA33 had significantly higher percentages of SLE-associated antibodies (<b>Figure 1</b>). Higher proportions of SLE patients with a high disease activity (41.7% vs. 24.7%) as well as lower levels of serum complement components (50.0% vs. 27.7%) were observed in the RA33-positive group (Both p&lt;0.05) (<b>Table 1</b>). Furthermore, CTD patients with positive anti-RA33 were more likely to suffer from mucocutaneous (46.4% vs. 33.2%, p=0.0361) and haematological involvement (51.8% vs. 35.6%, p=0.0200) as well as interstitial lung disease (25.0% vs. 11.8%, p=0.0108). ROC analysis revealed an area under the curve value of 0.634 (95% CI: 0.587 to 0.681) for anti-RA33 in the diagnosis of SLE, with a specificity and sensitivity of 92.9% and 13.5%, respectively. <h3>Conclusion</h3> This study reveals a significant association between anti-RA33 and the clinical features of CTDs, especially SLE, indicating a potential clinical significance of anti-RA33 in the management of SLE. <h3>References</h3> [1]Hassfeld W, Steiner G, Graninger W, et al. Autoantibody to the nuclear antigen RA33: a marker for early rheumatoid arthritis.Br J Rheumatol 1993;32(3):199-203. [2]Caporali R, Bugatti S, Bruschi E, et al. Autoantibodies to heterogeneous nuclear ribonucleoproteins. Autoimmunity 2005;38(1):25-32. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0350 DRUG SAFETY AND PREGNANCY OUTCOME IN INDIAN PATIENTS WITH RHEUMATOID ARTHRITIS (RA)
Authors: P. Aggarwal, B. Aggarwal, V. Gupta, P. Gupta
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Due to ethical issues conducting controlled trials to assess safety, teratogenicity of medicines to treat Rheumatoid Arthritis (RA) is not feasible and pregnant women are excluded from drug trials. Hence data concerning safety of arthritis medicines in RA is limited. To our knowledge no study is available from India regarding pregnancy outcome and drug safety in RA patients. <h3>Objectives</h3> Analyze safety of arthritis medicines and pregnancy outcome in Indian women suffering from RA. <h3>Methods</h3> Retrospective analysis of RA women with pregnancy treated at Punjab Rheumatology Immunology Centre, Ludhiana and DMC, Ludhiana between 2012 to 2022. Patients were classified as RA based on ACR/EULAR 2010 criteria. Compliance to treatment and additional medication usage was self-reported by the patients. Delivery of healthy baby was counted as successful while spontaneous abortion, MTP due to fetal abnormality were counted as adverse pregnancy outcome. <h3>Results</h3> 77 patients (Mean age 31.3 years) and 82 pregnancies were evaluated. 68 were successful. 10 patients had 11 spontaneous abortions out of whom 4 subsequently had successful pregnancy. Anticardiolipin antibodies were negative in 7, not available in 3. Patient with 2 spontaneous abortions had a successful pregnancy following low molecular weight heparin treatment throughout pregnancy despite negative anticardiolipin antibodies. 3 patients underwent MTP due to antenatal fetal defects (Table 1). Most commonly used medicines during pregnancy were Sulfasalazine(SSZ), Hydroxychloroquine(HCQ), Low dose Prednisolone, Azathioprine(AZA) (Table 1). No specific teratogenicity pattern was identified. 3 patients without Methotrexate(MTX) and 1 patient without MTX+Leflunomide washout had successful pregnancy. <h3>Conclusion</h3> To our knowledge this is the first study evaluating drug safety and pregnancy outcome in Indian RA patients. Most RA patients can have successful pregnancy. SSZ, HCQ, Azathioprine and low dose prednisolone are safe during pregnancy. Limited data indicates patients can have successful pregnancy without observing MTX washout but more data is required. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Parshant Aggarwal Speakers bureau: Novartis, not related to abstract submitted, Bharti Aggarwal: None declared, Vikas Gupta Speakers bureau: Janssen; not related to submitted abstract, Palak Gupta: None declared.
POS1148 OPTIMAL CUT-OFF POINT FOR ELECTROCARDIOGRAM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS ON HYDROXYCHLOROQUINE THERAPY
Authors: A. Herrero-Morant, J. Zubiaur-Zamacola, A. Margarida-de Castro, R. Pérez-Barquín, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Hydroxychloroquine (HCQ) is a widely used drug in Systemic Lupus Erythematosus (SLE) that can cause cardiac alterations such as arrhythmic events in the short-term and dose-dependent cardiomyopathy in the medium to long-term. The cardiological implications of HCQ accumulation in these patients in the medium to long-term is unknown. <h3>Objectives</h3> To assess the optimal cut-off point for electrocardiogram (ECG) in patients with SLE on HCQ therapy to prevent arrhythmic complications. <h3>Methods</h3> Single university hospital observational study of all consecutive SLE patients who had an ECG at baseline and at least one ECG at follow-up. New conduction disturbances were assessed by ECG, defined as atrioventricular block, bundle branch block or QT interval prolongation. ECGs were extracted from the medical record and interpreted at baseline and for 15.2 years (95%CI 13.24-17.16) of follow-up. We defined cumulative HCQ (cHCQ) as the total grams of HCQ that had been administered. A Receiver Operating Characteristic (ROC) curve analysis was performed to determine the optimal cut-off point for sensitivity and specificity. <h3>Results</h3> We studied 105 (93 female/12 male) SLE patients with a mean (±SD) age of 61.8±14.9 years. The mean daily dose of HCQ in our sample was 256 mg per day (<b>Table 1</b>). The ROC curve showed a moderate diagnostic ability for new conduction disturbances with an area under the curve of 0.69 (95% CI 0.59 - 0.77) (<b>Figure 1</b>). The highest efficacy cut-off point was cHCQ: 4097g (Sensitivity 15%; Specificity 100%) and the optimal cut-off point was cHCQ: 901g (Sensitivity 85%; Specificity 52.9%). This cut-off point was reached with a mean HCQ treatment in our sample of 9.7 years. High grade atrio-ventricular block was found in 5 patients. In all of them the cHCQ dose was over 901g. <h3>Conclusion</h3> According to our study, 901g of cHCQ dose is a good cut-off point for performing a protocolized ECG to rule out cardiac conduction disturbances in patients with SLE and chronic HCQ treatment. This is equivalent to 9.7 years of treatment with the mean HCQ dose use in our sample. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Alba Herrero-Morant: None declared, Jon Zubiaur-Zamacola: None declared, Adrián Margarida-de Castro: None declared, Raquel Pérez-Barquín: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Lilly, Bristol-Myers, Janssen, Galapagos and MSD, Consultant of: Abbvie, Pfizer, Roche, Lilly, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD, Novartis and Roche.
POS1195-HPR REPRODUCTIVE HEALTH IN AUTOIMMUNE RHEUMATIC DISEASES FROM THE PATIENT’S PERSPECTIVE: QUALITATIVE STUDY
Authors: I. Peláez-Ballestas, C. M. Skinner Taylor, L. Pérez Barbosa, A. Y. Lujano Negrete, M. E. Corral Trujillo, F. R. Arevalo Nieto, A. Aguilar-Leal, M. C. Rodriguez-Ruiz, G. Sandoval, M. G. Ríos Medina, A. Carrazco Chapa, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Reproductive health (RH), family planning (FP), and managing a high-risk pregnancy should be prioritized in the rheumatology consultation to achieve shared and respectful decision-making [1]. Lack of knowledge of reproductive health and poor communication during the consultation may lead to increased pregnancy complications in patients with ARDs. <h3>Objectives</h3> To describe and analyze patients' experiences with ARDs on reproductive health issues at the clinic of pregnancy and reproductive health in rheumatic diseases (CEER) in Mexico. <h3>Methods</h3> A descriptive qualitative study was conducted using semi-structured interviews following an interview guide. Women of childbearing age, suffering from ARD, with different socioeconomic, cultural, disability, and sexual diversity conditions were invited to participate. The face-to-face or virtual interviews were recorded and transcribed. A multidisciplinary team of researchers performed an independent and blinded thematic analysis. <h3>Results</h3> Twenty-one patients participated. The age media was 28 years (yrs.), 38% were married, 28.5% were free union and 28.5% were single; 33.3% were pregnant, 38% were in the preconception stage with the desire of pregnancy and 28.5% women who have already had children. The main rheumatologic diagnoses were rheumatoid arthritis (47.6%), systemic lupus erythematosus (47.6%), and mixed connective tissue disease (4.7%). Three main themes were identified: medications related to pregnancy and lactation, contraceptive methods, and pregnancy planning (Table 1). <h3>Conclusion</h3> The experiences of patients with rheumatic diseases were diverse, and the amount of biomedical knowledge of RH issues was limited in FP, decision-making, and prenatal or postnatal care. The patients recognized the relevance of a multidisciplinary team led by their rheumatologist to generate confidence in the quality of information and allow better decision-making according to patients' beliefs, preferences, and reproductive rights. <h3>Reference</h3> [1] UN: United Nations Fund for Population Activities (UNFPA), Informe de la Conferencia Internacional sobre la Población el Desarrollo, El Cairo, 13 de septiembre de 1994, 1995, A/CONF.171/13/Rev.1, available at: https://www.refworld.org.es/docid/4ad4349b2.html [Accessed on october 15, 2022] <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0243 ASSOCIATION BETWEEN THE GERIATRIC NUTRITIONAL RISK INDEX (GNRI) AND THE DISEASE ACTIVITY IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: M. Ardhaoui, J. Mahbouba, S. Zrour, I. Bejia, M. Touzi, N. Bergaoui
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Geriatric Nutritional Risk Index (GNRI) is a tool that assesses the risk of malnutrition-related complications in elderly patients. Some recent publications have suggested that the GNRI could predict disease activity in people followed for rheumatoid arthritis (RA) [1]. <h3>Objectives</h3> Our aim was to evaluate the correlation between the GNRI and the disease activity in elderly RA patient.s. <h3>Methods</h3> This is a cross-sectional study including patients followed for RA and aged at least 65 years. The GNRI was calculated for all patients: <i>GNRI = [1.489*albumin (g/L)] + [41.7 *(weight/WLo)]</i>, where WLo means ideal weight and was calculated from the <b>Lorentz</b> equations: for men: H-100-[(H-150)/4]; for women: H-100-[(H-150)/2.5](H: height). <h3>Results</h3> We included 63 patients (52 women and 11 men). The mean age was 68.17±4.35 years. The median duration of disease progression was 11 years with an IQR of [4-16]. The mean DAS28 was 3.72±1.48. The mean HAQ was 1.6±0.58. The median value of GNRI was 116.47 with an IQR of [106.6-125.12] and extremes ranging from 70.06 to 145.02. According to the GNRI, 58 patients (92.1%) had a GNRI &gt; 98 indicating no nutritional risk, 2 patients (3.2%) were low risk with GNRI between 92 and 98, no patient had a GNRI between 82 and 92 indicating moderate risk and 3 patients (4.8%) had a GNRI &lt; 82 indicating a high risk of malnutrition-related complications. After statistical analysis, we found significant association between GNRI and DAS28 score (p=0.05). We also found a significant association between GNRI and higher ESR (p=0.03), CRP (p&lt;0.001) and higher daily doses of corticosteroids (p=0.024). However, we did not found significant association between the GNRI and advanced age (0.11), duration of RA progression (p=0.07), VAS of pain (p=0.2) or with HAQ score (p=0.06). <h3>Conclusion</h3> Our results showed that the GNRI is associated with DAS28, inflammatory biomarkers and higher corticosteroid doses. The GNRI could be used as a simple and reliable tool to assess both nutritional status and disease activity in RA elderly patients. <h3>Reference</h3> [1] Tokumoto H and al. Association between Bone Mineral Density of Femoral Neck and Geriatric Nutritional Risk Index in Rheumatoid Arthritis Patients Treated with Biological Disease-Modifying Anti-Rheumatic Drugs. Nutrients. 2018 Feb 18;10(2):234. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0829 PROGRESSION OF ILD (INTERSTITIAL LUNG DISEASE) IN PFT (PULMONARY FUNCTION TEST) AND HRCT (HIGH RESOLUTION COMPUTERIZED TOMOGRAPHY) ACCORDING TO CTD (CONNECTIVE TISSUE DISEASE) IN 12 MONTHS
Authors: C. L. Garcia Gomez, M. Enjuanes, E. Abad Plou, L. Vega-Álvarez, O. Ibarguengoitia, I. Calvo, E. Galindez, J. M. Blanco, M. R. Exposito-Molinero, I. Torre, E. Cuande, A. R. Inchaurbe, I. Gorostiza, M. L. García Vivar, M. E. Ruiz Lucea
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> ILD is an important cause of morbidity and mortality in CTD. Moreover, it can be the first clinical feature of a CTD. <h3>Objectives</h3> To evaluate progression of ILD in 12 months through HRCT and PFT according to the kind of CTD (systemic sclerosis, myositis, Sjögren's syndrome, rheumatoid arthritis, mixed connective tissue disease, systemic lupus erythematosus), vasculitis, sarcoidosis and interstitial pneumonia with autoimmune features (IPAF). <h3>Methods</h3> A restrospective single tertiary center cohort study in CTD-ILD outpatients seen between 2012 and 2022. Sociodemographic, clinical and serological data, PFT and HRCT results were collected. ILD patterns were classified into usual interstitial pneumonia (UIP), inconsistent UIP, nonspecific interstitial pneumonia (NSIP), fibrosing NSIP, organizing pneumonia (OP), interstitial lymphoid pneumonia and associated to sarcoidosis. Progression of ILD was defined in PFT as: decline ≥ 10% in FVC ≥ 15% in DLCO. Progression of ILD in HRCT was considered according to radiologists'criteria. <h3>Results</h3> Data regarding 83 ILD-CTD patients is shown in Table 1. 54,1% of the patients complained of dyspnea at diagnosis of ILD. Immunosuppression prescribed is shown in Table 1. Treatment was not required in all cases at. diagnosis of ILD. Pulse steroids, mycophenolate and rituximab are some of the most prescribed treatments. UIP was the most prevalent pattern in 40% of the patients with RA (rheumatoid arthritis) but also was present in 28% of non-RA patients. 40% of RA and 28% of non-RA had UIP. Image 1 shows progression in HRCT and PFT per CTD. Globally, 21,7% (n 14) of the patients progressed according to HRCT criteria and 16,7% (n 12) according to PFT criteria. <h3>Conclusion</h3> Close follow-up and treatment show non-progression in approximately 80% of the patients. In our series, patients with more progression (as found in literature) are systemic sclerosis, RA and IPAF. More studies must be done to identify best treatments and predictors to avoid progression of ILD. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0245 IMPACT OF EXTRA-ARTICULAR RHEUMATOID ARTHRITIS MANIFESTATIONS ON ATLANTOAXIAL SUBLUXATION
Authors: H. Ferjani, H. Bettaieb, D. Ben Nessib, D. Kaffel, K. Maatallah, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The cervical spine is frequently affected during RA. It's the third joint location after the hands and feet [1]. <h3>Objectives</h3> The objective of our work was to investigate the association between atlanto-axial subluxation (AAS) and the presence of extra-articular manifestations (EAM). <h3>Methods</h3> This is a cross-sectional comparative, single-center and hospital-based study of 102 RA patients (ACR/ EULAR 2010). Population was divided into two groups: Group 1 (study group) including 51 patients with AAS and Group 0 (control group) including 51 RA patients without AAS. AAS was defined as: the presence of an anterior C1C2 diastasis on the cervical spine radiograph in hyperflexion and/or by the presence of anterior, posterior, lateral or rotational C1C2 dislocation on MRI with/or without inflammatory signal. <h3>Results</h3> The study group (G1) consisted of 37 women and 14 men (M/F sex ratio = 0.37). The control group (G0) consisted of 40 women and 11 men (M/F sex ratio =0.28). The mean age was 60.3 ± 14.1 and 59 ± 11.3 years in G1 and G0, respectively. Median disease duration was 144 [6-480] and [5-216] months in G1 and G0 respectively. In G1, the median time to onset of AAS was 48 months [0-492]. At AAS diagnosis, EAM were present in 49% of G1 patients: dry ocular and/or mouth syndrome (60%), pulmonary involvement (16%) (3 cases of usual interstitial pneumonia and one case of constrictive bronchitis) and rheumatoid subcutaneous nodules (24%). Furthermore, 30 patients of G1 had bone densitometry. Osteoporosis and osteopenia were found respectively in 66% and 26% of cases. In the control group, only 3.9% of G0 patients had EAM. It was dry ocular syndrome in 2 patients. Bone densitometry, performed in 34 patients, was normal in 26.5% of cases. Osteoporosis and osteopenia were found respectively in 35.3% and 38.2% of patients. In analytical study, patients of G1 had higher prevalence of EAM (p&lt;0.001) and osteoporosis (p=0.012). Though, no association was found between the presence of AAS and osteopenia (p=0.79). <h3>Conclusion</h3> In this work, patients with AAS had significantly more EAM and osteoporosis. A regular monitoring of cervical spine radiographic assessment in these patients is highly recommended to prevent such complication. <h3>Reference</h3> [1] Zhu S, Xu W, Luo Y, Zhao Y, Liu Y. Cervical spine involvement risk factors in rheumatoid arthritis: a meta-analysis. Int J Rheum Dis. 2017;20(5):541‑9. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.